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Using resident reports of quality of life to distinguish among nursing homes
- Authors:
- KANE Robert L., et al
- Journal article citation:
- Gerontologist, 44(5), October 2004, pp.624-632.
- Publisher:
- Oxford University Press
The authors used measures created to assess the quality of life (QOL) of nursing home residents to distinguish among nursing facilities. They statistically adjusted scores for 10 QOL domains derived from standardized interviews with nursing home residents for age, gender, activities of daily living functioning, cognitive functioning, and length of stay, and then we aggregated them to the facility level. The authors then compared the patterns across a sample of 40 facilities. They correlated facility characteristics with QOL scores. The pattern of QOL scores for each of the 10 domains was generally consistent within a given facility. Although resident characteristics played a major role in explaining variance, there were significant effects of facilities as well. Some modest relationships were found between facility characteristics such as ownership, percentage of private rooms, and rural–urban location and facility QOL scores. No effect of facility size was detected. This article shows that it is possible to differentiate among facilities on the basis of resident self-reported QOL.
Families and assisted living
- Authors:
- GAUGLER Joseph E., KANE Robert L.
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.83-99.
- Publisher:
- Oxford University Press
Despite growing research on assisted living (AL) as a residential care option for older adults, the social ramifications of residents' transitions to AL are relatively unexplored. This article examines family involvement in AL, including family structures of residents, types of involvement from family members living outside the AL facility, and outcomes for these family members. The authors reviewed current literature utilizing the MEDLINE, PsycINFO, and CINAHL databases to identify AL studies that examined issues pertaining to families or informal care. Following the screening of abstracts, 180 reports were retrieved for further review and 62 studies selected for inclusion. Families visit residents frequently and provide a wide range of instrumental assistance but provide only minimal personal care. Studies of family outcomes indicated relatively high satisfaction but potential care burden as well. How family care and involvement occurs in AL in relation to formal care provision and whether various types of formal/informal care integration influence family outcomes remains unclear. The authors suggest a research agenda that attempts to tease out causal relationships for family involvement, differentiate family roles, and implement longitudinal analyses for a range of family outcomes.
Improving health care for assisted living residents
- Authors:
- KANE Robert L., MACH John R.
- Journal article citation:
- Gerontologist, 47(3), December 2007, pp.100-109.
- Publisher:
- Oxford University Press
The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. It draws on a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary health care and other health services for AL residents. Results found AL residents are frequently frail older persons who need good chronic care. The predominant care models today do not respond adequately to this challenge. Medical care for AL residents is currently practiced very much like that for persons living in the community. The potential for using the aggregation of patients has not been effectively tapped. The authors review some managed care models from other elements of long-term care, including the Evercare model, to look for ways that might be adapted. However, the current funding approach emphasizes living settings rather than inherent client characteristics. A research agenda might include ways to improve communication between AL and medical providers and to get AL staff more actively involved in daily care. Research support might produce the data necessary to entice the Centers for Medicare and Medicaid Services into changing its current reimbursement policies to create a climate better suited to delivering good chronic disease care in AL facilities.